Individual provider Active NPI

Adham Abdel Mottalib, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
National Provider Identifier
1740774892
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
295545 Issued in MA
Practice address
1 Joslin PL
Boston, MA 02215-5306
Phone
(617) 309-2695
NPI assigned
Jun 20, 2018
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 295545 MA Primary

Addresses

Primary practice location

1 Joslin PL
Boston, MA 02215-5306

Mailing address

1 Joslin PL
Boston, MA 02215-5306

Other practice location 1

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-9344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230413002759 MA Practitioner - EndocrinologyPractitioner - Internal Medicine 0648645176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joslin Clinic IncGroup PAC ID 5092794883, 53 clinicians

Practice addresses (Care Compare)

1 Joslin PL
Boston, MA 02215-5306
Phone (617) 309-5708

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
295545MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 1, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 1, 2023 Accepting new patients
Joslin Clinic Inc CurrentSince Jun 1, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
Beth Israel Deaconess Medical Center, Inc. PastSince Jun 1, 2023 Accepting new patients

Locations

1 Joslin Pl
Boston, MA 02215
Phone (617) 309-2400

1 Joslin Pl
Ste 201
Boston, MA 02215
Phone (617) 309-5708

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: aabdelmottalib106394@direct.bilh.masshiway.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1740774892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JOSLIN PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JOSLIN PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155306",
            "telephone_number": "617-309-2695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-9344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDEL MOTTALIB",
        "first_name": "ADHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "295545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.